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Sleeve gastrectomy outcome found to be independent of physician preferences
Sleeve gastrectomy outcome found to be independent of physician preferences
by Denise B. Hensley
In a major study presented nationally by the Underwood Center for Digestive Disorders at Houston Methodist, sleeve gastrectomy was found to have equally safe patient outcomes independent of energy devices, staple types, staple height and staple line oversewing.
“The differences in technique and devices used didn’t make it worse nor did it make it better,” says Patrick Reardon, MD, FACS, Professor of Clinical Surgery, Academic Institute Houston Methodist. “This study will make surgeons take a step back and be more objective,” he says, pointing out that hard data is an important factor in decision-making for physicians.
Patrick Reardon, MD FACS
A follow-up study of the specific cost differential will be conducted next. As the physician representative of Houston Methodist’s supply chain, Reardon asked to have a study conducted of all such patients between 2005 and 2019. Of the 1,161 patients who met the requirements for the study, 25 received postoperative blood transfusion, nine had postoperative bleeding, two had staple line leak and 28 had combined postoperative complications.
The use of different staple types did not show any significance in rate of bleeding (0.56 percent difference), blood transfusion requirement (0.16), leak (1.00) or composite events (0.21). Similarly, different staple heights did not show any correlation in rate of bleeding (0.77 percent difference), blood transfusion (0.38), leak (1.00) or composite event (0.50). Different staple line management did not show any correlation to the rate of bleeding (0.44 percent difference), blood transfusion requirement (0.92), leak (1.00) or composite event (0.95). No significant difference was seen in different energy devices in rate of bleeding (0.49 percent difference), blood transfusion (0.82), leak (0.73) or composite events (0.92).
The cohort consisted of 918 women and 243 men with an average age of 43. They averaged 5-feet-5 inches and weighed 260 pounds. “‘Value’ in healthcare is known as the best outcome you can get for the lowest sustainable cost,” Reardon says. “That’s why this is a very important finding.”